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available at http://www.ncbi.nlm.nih.gov/pubmed/30929730 Editorial Comment: Total motile sperm counts are commonly used by reproductive endocrinologists to determine whether intrauterine insemination is possible. Consequently urologists have argued that if the total motile count can be increased with male therapy, the need for in vitro fertilization may be obviated. But is the premise that total motile count predicts intrauterine insemination outcome correct? We know how arbitrary motility is in general, so we might expect not. That is what these authors observe in showing that total motile count does not predict intrauterine insemination outcome well. Certainly men with total motile counts less than 2 million fare poorly with their partners in intrauterine insemination, and by rough estimation intrauterine insemination outcomes seem to increase with total motile counts increasing to 7 million but that is where the relationship ends. What we can conclude from this article is that for intrauterine insemination a total motile count of greater than 2 million is necessary and that outcomes significantly worsen for women older than age 37 years, which is no surprise. But after 2 million we as urologists should not stress that increasing total motile counts will improve chances in intrauterine insemination, as the data just aren’t there. Craig Niederberger, MD MALE INFERTILITY 853 Copyright © 2019 American Urological Association Education and Research, Inc. Unauthorized reproduction of this article is prohibited.